{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:07:12Z","timestamp":1792595232518,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2012,5,17]],"date-time":"2012-05-17T00:00:00Z","timestamp":1337212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Changing trends in head and neck cancer (HNC) merit an understanding of the late effects of therapy, but few studies examine dysphagia beyond 2 years of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A case series was examined to describe the pathophysiology and outcomes in dysphagic HNC survivors referred for modified barium swallow (MBS) studies \u22655 years after definitive radiotherapy or chemoradiotherapy (January 2001 through May 2011). Functional measures included the penetration\u2010aspiration scale (PAS), performance status scale\u2013head and neck (PSS\u2010HN), National Institutes of Health Swallowing Safety Scale (NIH\u2010SSS), and MBS impairment profile (MBSImp).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Twenty\u2010nine patients previously treated with radiotherapy (38%) or chemoradiotherapy (62%) were included (median years posttreatment, 9; range, 5\u201019). The majority (86%) had oropharyngeal cancer; 52% were never\u2010smokers. Seventy\u2010five percent had T2 or T3 tumors; 52% were N+. The median age at diagnosis was 55 (range, 38\u201072). Abnormal late examination findings included: dysarthria\/dysphonia (76%), cranial neuropathy (48%), trismus (38%), and radionecrosis (10%). MBS studies confirmed pharyngeal residue and aspiration in all dysphagic cases owing to physiologic impairment (median PAS, 8; median NIH\u2010SSS, 10; median MBSImp, 18), whereas stricture was confirmed endoscopically in 7 (24%). Twenty\u2010five (86%) developed pneumonia, half requiring hospitalization. Swallow postures\/strategies helped 69% of cases, but no patient achieved durable improvement across functional measures at last follow\u2010up. Ultimately, 19 (66%) were gastrostomy\u2010dependent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Although functional organ preservation is commonly achieved, severe dysphagia represents a challenging late effect that may develop or progress years after radiation\u2010based therapy for HNC. These data suggest that novel approaches are needed to minimize and better address this complication that is commonly refractory to many standard dysphagia therapies. Cancer 2012. \u00a9 2012 American Cancer Society.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.27631","type":"journal-article","created":{"date-parts":[[2012,5,17]],"date-time":"2012-05-17T16:05:03Z","timestamp":1337270703000},"page":"5793-5799","source":"Crossref","is-referenced-by-count":359,"title":["Late dysphagia after radiotherapy\u2010based treatment of head and neck cancer"],"prefix":"10.1002","volume":"118","author":[{"given":"Katherine A.","family":"Hutcheson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan S.","family":"Lewin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise A.","family":"Barringer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asher","family":"Lisec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.Brandon","family":"Gunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.S.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Christopher","family":"Holsinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,5,17]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.0079"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(00)00435-1"},{"key":"e_1_2_6_4_2","first-page":"358","article-title":"Movement trajectories during percutaneous stimulation at rest of the hyolaryngeal muscles in head and neck cancer patients treated with radiation therapy","volume":"25","author":"Martin S","year":"2010","journal-title":"Dysphagia."},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21022"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.36.4596"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_2_6_8_2","volume-title":"Manual for the Videofluorgraphic Study of Swallowing","author":"Logemann J","year":"1993"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19960601)77:11<2294::AID-CNCR17>3.0.CO;2-S"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417897"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-006-9029-4"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-008-9185-9"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.116.5.1251"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20299"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2007.33"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.04.083"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa053422"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(83)90247-7"},{"key":"e_1_2_6_19_2","first-page":"3","article-title":"HPV and tts effect on head and neck cancer prognosis","volume":"8","author":"Gillison M","year":"2010","journal-title":"Clin Adv Hematol Oncol."},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2011.0053"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.8841"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.02.049"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.10.002"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000217278.96901.fc"},{"key":"e_1_2_6_25_2","first-page":"443","article-title":"The effect of adherence to swallowing exercises on swallowing outcomes in head and neck cancer patients treated with radiotherapy","volume":"26","author":"Shinn E","year":"2011","journal-title":"Dysphagia."},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31815659b0"},{"key":"e_1_2_6_27_2","first-page":"381","article-title":"Preventative exercise for dysphagia following head\/neck cancer","volume":"22","author":"Carnaby\u2010Mann G","year":"2007","journal-title":"Dysphagia"},{"key":"e_1_2_6_28_2","first-page":"471","article-title":"Gastrostomy tube placement in patients with hypopharyngeal cancer treated with chemoradiotherapy: factors affecting placement and dependence","volume":"26","author":"Bhayani M","year":"2011","journal-title":"Dysphagia."},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0347(200008)22:5<474::AID-HED6>3.0.CO;2-I"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.27631","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.27631","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T12:15:39Z","timestamp":1760271339000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.27631"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,17]]},"references-count":28,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["10.1002\/cncr.27631"],"URL":"https:\/\/doi.org\/10.1002\/cncr.27631","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5,17]]}}}